The picture album in my mind is full of food. It leaves room for little else. Breakfast, lunch, and dinner—dissected and cataloged. It would seem all I ever do is eat. Or not eat.

My 15-year-old Birthday. I’m told there was a sleepover. A group of friends from school gossiping about boys and teachers. I see a picture my mom took; a friend is dressed up in a mermaid costume and everyone is laughing. I am noticeably absent. Perhaps I was staring down the sugar-free, fat free ice cream cake my mom had special-ordered from TCBY. Because that’s all I can remember from that day.

A family vacation to Disney World. I’m trying hard, I swear I am. My sister and I run, carefree through the park, laughing at inside jokes. We watch a parade as it rolls down the street. Fireworks light up the night sky, casting shadows across the ground. This is what I tell people when they ask me about my trip. But if I’m telling the truth, all I remember is the fight I had with my dad over whether I would eat another bite of chicken.

The first day of college, standing in front of the salad bar, I have a panic attack when I realize they don’t have fat free dressing. I don’t remember what my dorm mates looked like or the classes I took. But I remember that fucking dressing.

My wedding day. Everyone tells me to stop a moment and take it all in—you only get married once they say. I look through my wedding album, am amnesiac patient sifting through the ruins of her life. The hair, the nose, the awkward rolls of fat where I wish there were none. That girl in the pictures is clearly me. I flip through and see a picture of a towering cake, laced with delicate, pink fondant flowers. 400 calories a slice easily. And now I remember. While everyone else was dancing and drinking and being merry, I was worried about how much cake my husband had shoved in my mouth.

This is what my memory has become. Moments defined by my relationship to food. A life defined not by what I achieved, where I’ve been, or whom I loved. Only by what I ate.

If I could I’d erase all these images. Hope to make room for something else. But there in their too deep, and I am tired of fighting.

Recently, the U.S. Preventative Services Task Force recommended that doctors refer all patients with a body mass index of 30 or more to a program designed to promote weight loss. A successful program, according to the panel, combines counseling sessions with concrete weight-loss goals, nutrition advice, and education on setting limits and recognizing barriers to change. The recommendation was met with mixed reviews from doctors and politicians involved in the healthcare debate. Some cited it as a “long-overdue” prod to physicians while others acknowledged the additional responsibility it would place on doctors who are already facing time and resource constraints.

What the debate skims over, however, and what may be the most important point is not a single study demonstrates the long-term benefits of an intensive weight loss program for health. This oversight is at the crux of the war on obesity and America’s obsession with weight loss.

One of the central misconceptions fueling the task force’s recommendation is that body weight alone is indicative of health. Many studies have indicated that weight, when viewed in conjunction with other lifestyle habits like exercise, is not related to disease or early death except in the morbidly obese. Other studies point out that equal numbers of thin and fat people exhibit unhealthy eating habits and whether or not those habits become externally apparent is largely determined by genetics. To assume all fat people are unhealthy and all thin people are healthy is prejudicial and does a disservice to both groups.

Another misconception is that everyone who is fat must suffer from some form of disordered eating. In reality many people with a BMI above 30 are healthy adults who exhibit moderate eating and exercise habits. Likewise, many people at a “normal” BMI of 18.5 to 24.9 do display maladaptive eating habits. Using BMI alone as the criteria for admission into a free counseling program both sets the stage for further discrimination against fat people and excludes many “normal” weight individuals who might benefit. In short, It is a grave mistake to assume everyone at a “normal” BMI is making healthy choices and everyone above a “normal” BMI is not.

As part of the initiative, doctors are urged to refer obese individuals to programs where weight loss is the primary goal and benchmark for success. There are many problems with this. First, weight loss programs fail for about 95% of dieters and ultimately cause more health problems from the resulting weight cycles. Second, there is not sufficient evidence linking weight loss with improved health outcomes in the long run, which the task force openly admits but appears to dismiss in another classic case of succumbing to popular culture rhetoric about dieting. The task force states that in some cases, programs include exercise sessions. From an evidence-based perspective, this should be priority number one. Research has shown dramatic improvements in health from exercise alone, and obese but fit people are as healthy as fit people falling within the normal BMI criteria. A focus on weight loss over increased physical activity gives people an inaccurate tool for gauging health.

Dr. Jack Der-Sarkissian notes that more than half of all obese patients are never told they need to lose weight, and that’s just “not fair to the patient.” Hmmm…. Let’s talk about what’s really not fair. It’s not fair that doctors assume all fat people have homogenous eating habits and weight loss is the lifesaving miracle panacea. It’s not fair that doctors assume a fat person is automatically unhealthy and on the flip side, a thin person is healthy. It’s not fair that so many medical problems a fat person encounters are attributed to weight with no further investigation. It’s not fair that people at “normal” weights are rarely offered nutritional advice, diagnostic testing, or counseling because they are assumed to be healthy. It’s not fair that so many people with diagnosable eating disorders do not get the treatment they need because they don’t meet certain weight criteria, while the government wants to the foot the bill for every fat person to a enter a weight loss program.

When will health officials come to realize that both physical and mental health are independent of body size and the people who could actually benefit from counseling fall all along the weight continuum.

DIET: that dirty four-lettered word that is so ingrained in our national vocabulary that it’s mention is akin to discussing the weather.

“What’s the forecast for tomorrow?” you ask.

“A high of 1200 calories with a slight chance of deprivation.” How gloomy.

Dieting has become as American as baseball and apple pie, that is, as long as you make it a slice of sugar free, fat free pie.

Yet despite how often we talk about dieting, very few actually succeed in losing weight and keeping it off. So why do we persist? Are we all insane, as a popular quote would suggest?

“The definition of insanity is doing the same thing over and over again and expecting different results.”

Or maybe we’ve been bamboozled by an industry that profits off of our failures, an industry that designs a faulty product and then places the blame on the buyer? Today I challenge you all to embark on a different kind of diet: the anti-diet. Let go of all your complicated food rules and beliefs about “good” and “bad” foods and begin to trust your body to tell you what it wants and needs.

To provide you with some motivation, I’m counting down the top ten reasons to ditch dieting for good.

10. Dieting wrecks havoc on your metabolism.

Dieting slows the metabolism down tremendously, as the body enters what it assumes to be a period of famine. And while fat people who lose large amounts of weight may look similar to a naturally thin person, their bodies are actually behaving more like that of a starving person. In other words, a fat person who loses weight will not acquire the health characteristics of a naturally thin person. On average, the metabolism slows so that a formerly fat person burns about 24% fewer calories per square meter of their body’s surface area than a naturally thin person. By avoiding diets, you can ensure your metabolism is functioning at its optimal level.

9. Your body produces hormones that fight against weight change.

Your body has a natural set point for weight, largely determined by genetics, at which it feels most comfortable. Deviating much beyond this point triggers a cascade of hormones designed to resist further weight fluctuations. These hormones can stimulate or suppress appetite, decrease or increase metabolism, and encourage or discourage activity. Dieting interferes with the mechanisms that regulate set point and makes it difficult to respond to hormonal cues. Much like a broken gas gauge on a car, dieting makes it difficult to tell when the tank is full or running on empty.

8. Dieting can lead to many psychiatric problems.

Here’s a novel idea: your body, as adept as it is at carefully regulating all your bodily systems, cannot tell the difference between a diet and unintentional starvation. And starvation has been shown to cause a lot of psychological problems. In the classic Minnesota Starvation Study, healthy men were put on 1,600 calorie diets with the intention of losing 25% of their body weight. Over the course of the experiment, the men experienced what head researcher Dr. Ancel Keys came to call “semistarvation neurosis.” They became nervous, anxious, withdrawn and overly critical of their appearance and weight. Many exhibited signs of depression, losing their ambitions, interests, sense of humor, and desire for social interaction. They became obsessed with food and many developed odd food rituals. And to think this all happened on 1,600 calories per day. Many popular diets today prescribe much less!

7. Dieting wastes a lot of time and energy.

As noted by a participant in the Minnesota Starvation Study the act of restricting food “made food the most important thing in one’s life.” Whether your counting calories, weighing out just right portions, or dreaming about all the food you wish you could be eating, dieting can quickly become an all-consuming undertaking, often at the expense of other areas of your life. When we deny ourselves food we enjoy in favor of “healthy” foods we dislike, a lot of time gets spent fantasizing about that forbidden food.

6. Dieting robs a lot of the pleasure from eating and can make for more complicated social situations.

Despite what many popular diets lead you to believe, getting pleasure from food does not make you a hedonistic, weak-willed person. Eating can and should be a pleasurable experience. Think about digging into a big stack of fluffy pancakes on a lazy Sunday morning, eating a slice of cake on your Birthday, or clinking champagne glasses with friends and family on New Years Eve. Food is a part of many of social situations, and when your web of complex food rules keeps you sidelined from digging in with everyone else it can be an isolating experience.

5. 95% of dieters regain the weight and then develop a higher weight set point.

Because of the numerous regulatory checks that your body employs, in the end, dieting is more synonymous with weight gain than weight loss. It slows metabolism, increases the body’s efficiency at getting calories from food, increases appetite, decreases activity levels, lowers your body temperature, breaks down muscle tissue, and increases fat storing enzymes. All these checks ensure you are on the fast track to gaining back any lost weight. And because our bodies are programmed to protect us from weight loss but aren’t too concerned with weight gain, they settle at a slightly higher set point than they were previously at. In other words, the same amount of calories you were once eating to maintain weight X are now how many you need to eat to maintain X+10lbs.

4. Dieting and weight cycling causes a lot of the problems that excess weight is blamed for like heart disease, high blood pressure, high cholesterol, and liver damage.

It’s a classic case of what came first, the chicken or the egg? Many people see a correlation between excess weight and disease and assume weight is the cause, when in reality the relationship isn’t so straightforward. What often underlies conditions like heart disease is the damage done to the body by losing and regaining the same weight over and over again, the same cycling that leads to higher set point weights.

3. You don’t need to diet to maintain your body’s healthy weight.

Too many people are under the impression that without constant vigilance the pounds will keep piling on, when in fact, this is far from the truth. A scientist at the University of Vermont, Ethan Sims, conducted an experiment that was the mirror image of the Minnesota Starvation Study. Instead of looking at the effects of calorie restriction, Sims put men on a calorie dense diet. In order increase their weight by 20% above their natural set point the men had to eat as much as 10,000 calories for up to six months time. Sims discovered that the amount of weight the men should have gained based on a simple calories in versus calories out equation was much more than they actually gained. Their bodies fought hard to maintain their natural set point, and at the conclusion of the study they returned to these weight without effort. Your body knows the weight it is healthiest at and will fight you to maintain that weight. Ironically, you have to diet to NOT maintain your healthy weight. Watch a documentary that puts participants through a similar weight gain experiment here.

2. Being thin does not necessarily make you healthier. Moderate activity and healthy, moderate food choices make you healthier.

Fit, active people are much healthier than sedentary individuals, regardless of weight. In fact, fit obese people are healthier than thin sedentary individuals and just as healthy and thin active individuals. When fat people exercise, they reap all the benefits even without an accompanying weight loss. In other words, losing weight will not make one healthy but exercising will. Several studies also indicate that fostering an active lifestyle increases self-confidence and acceptance while dieting often has the opposite effect. Read more.

1. Dieting is NOT about loving and respecting your body.

How many times have your heard someone say (or said yourself) “I’m trying to lose weight because I want to take care of myself?” While the intention is good, dieting is a misguided attempt at promoting health and well-being. Choosing a healthy, varied diet, staying active, and accepting your body in its present state sends a lot more powerful message if you ask me. You wouldn’t tell your partner or your best friend, “I’d love you more if only you were….(fill in the blanks).” So why do we repeatedly tell ourselves this message by trying to lose weight? Love and respect come from an understanding that I am a complete, whole person as I am.

For a great resource on the research behind these reasons check out Big Liberty’s blog. Or pick up a copy of the book Health at Every Size by Linda Bacon, The Obesity Myth by Paul Campos or Rethinking Thin by Gina Kolata.

Back in April of 2010 I wrote a blog entitled “Life, Liberty, and the Pursuit of Fatness” discussing the fat acceptance movement. I questioned its motives, pointed the finger at what I thought were its unreasonable claims, and flat out refused to believe that being fat could be healthy. You see, like most people who have grown up in the “fat is bad” era, when I heard news reports claiming we are drowning in a nationwide obesity crisis (talk about a loaded expression), I jumped on the lifeboat.

It took a good amount of critical research, reading between the lines, and turning a deaf ear to the popular media fat-bashing machine before I would be willing accept the possibility that all my nutritional indoctrination might be wrong. But wrong I was.

A lot of current claims about the obesity crisis are based on misinformation. In 2002, Richard Carmona, the former surgeon general described obesity as “the terror within, a threat that is every bit as real to America as the weapons of mass destruction.” And how could it not be when the Center for Disease Control reported that more than 400,000 Americans die from being overweight or obese? This shocking statistic became the headline for thousands of popular media articles and pumped millions of dollars into scientific research aimed at curing obesity.

But in 2005, an updated report from the CDC acknowledged that the previous analysis suffered from computation errors and reduced the estimate fifteen-fold, taking the 400,000 deaths down to 26,000. Further separating “overweight” and “obese” individuals from “extremely obese” individuals (BMI over 35) decreases the number even more, as most deaths are clustered in the BMI over 35 category. When “overweight” individuals (BMI 25-30) are compared to “normal” weight individuals (BMI 18.5-24) an even more interesting statistic surfaces. Overweight individuals actually live longer than normal weight people.

Research from a Canadian national health survey following more than 11,000 adults looked at the relationship between BMI and longevity. Compared to people who fell into the normal-weight category:

– Those classified as underweight were 73% MORE likely to die
– Those classified as extremely obese were 36% MORE likely to die
– Those classified as obese had about the SAME risk of death
– Those classified as overweight were 17% LESS likely to die

Eric Oliver, a political scientist at the University of Chicago says the obesity epidemic is really “a relatively small group of scientists and doctors, many directly funded by the weight loss industry, (who) have created an arbitrary and unscientific definition of overweight and obesity. They have inflated claims and distorted statistics on the consequences of our growing weights, and they have largely ignored the complicated health realities associated with being fat.”

“So what?” you may be thinking. “Just because people are living longer doesn’t mean they are living healthier lives. Everyone knows fat people are unhealthy.”

While weight is a causal factor in a couple diseases, say osteoarthritis or sleep apnea, there isn’t much evidence that excess body fat itself causes disease. Instead other variables might be at play. For example, most overweight individuals report weight cycling at some point during their lives. A single weight cycle, think a failed crash diet, has been shown to damage blood vessels and increase the risk for cardiovascular disease. Rat studies indicate that obese rats that have weight cycled have very high blood pressures compared to rats that have maintained a consistent weight.

Additionally, there is a weak association among obesity and hypertension in cultures where dieting is uncommon. Could the “cure” for hypertension actually be the “cause?”

Research also finds that overweight people report feeling more stress and anxiety, both of which are a risk factor for diabetes and cardiovascular disease. In countries where there is less stigma attached to weight, overweight individuals are not prone to the same diseases associated with obesity in the United States. Additionally, when researchers looked at a group of more than 170,000 U.S. adults, they found the differences between actual weight and perceived ideal weight was a better indicator of mental and physical health than BMI. In other words, feeling fat has a stronger implication for health than being fat.

Research indicates that activity level, combined with other lifestyle choices like sleep and social habits, are more related to health than body fat percentage. For example, one study found that obese men classified as “fit” based on a treadmill test have similar death rates as lean men classified as “fit.” The obese fit men actually had death rates one-half those of the lean but unfit men.

What about type 2 diabetes? This disease, characterized by a reduced sensitivity to insulin, is much more common among obese individuals, and thus, obesity is often blamed for its emergence. But is it possible that insulin resistance causes obesity? In this classic which came first scenario, research suggests that high levels of insulin appear before weight gain in future diabetics. This finding is consistent with the “thrifty genotype” theory, which views insulin resistance as a helpful adaptation for storing more fat during times of famine. Because fat cells do not develop insulin resistance as readily as other cells, they allow glucose and nutrients to enter, promoting excess fat storage and weight gain. The added weight gain further increases insulin resistance and the cycle continues. So is weight loss the answer?

I’ll give you a second to guess what my answer is going to be (cue the Jeopardy music).

What is a resounding NO!?! A review of controlled weight loss studies for type 2 diabetes shows that initial improvements were short-lived, and study participants returned to their starting values within eighteen months, even when they maintained their weight loss. In another study, women who underwent liposuction resulting in an average loss of twenty pounds of body fat did not show improvements in insulin sensitivity. What have been shown to improve diabetes time and time again are changes in nutrition and increased activity, even without any resulting weight loss.

What’s most unfortunate about our culture’s association between body size and health is that it paves the way for fat bashing, prejudice, and discrimination. We demonize fat, and as a result, view the people carrying it around as vessels for evil. In our quest to cure obesity, we ostracize a segment of the population. We confer them with labels like lazy, sick, bad, stupid, and unhealthy. We spend so much time trying to rid the world of “fatties” that we lose sight of what is really important: health. If we could refocus our attention on finding health at any and every size, and let go of the notion that only “average” or “normal” weight people can be healthy we could start to see actual improvements in blood pressure, cholesterol, diabetes, and a slew of other conditions previously linked primarily with weight.

In the end, by focusing so much on weight, we are preventing people from finding what every weight-loss venture promises to deliver: a long, happy, and healthy life.

Note: For further reading please check out the book Health and Every Size by Linda Bacon or refer to her blog at www.healthateverysizeblog.wordpress.com. Another great resource that promotes health and every size is thefatnutritionist.com. If you would like more information on the research I am referencing please comment or send me a message.

Okay so that’s not true at all… the baby was probably cringing at all the sugar coursing through my digestive system (nothing like getting them hooked at an early age right?) Truth is, I really wanted a doughnut and a decaf coffee, so without much thought at all, I drove to Tim Horton’s and purchased the following:

It was delicious and thoroughly enjoyed in moderation. No feelings of guilt, regret, or panic. Will I be eating more doughnuts again anytime soon? Probably not…although I did enjoy a cupcake the other day for my father-in-laws Birthday. But hey, it wasn’t a doughnut. Cupcakes and doughnuts are completely different food groups. Duh!

“Expect to gain 25-30 lbs over the next 30 weeks,” the doctor said. “Really,” she paused to chuckle “after week 20 it’s going to be hard not to gain a pound a week.”

Those words sound eerily familiar. Almost eleven years ago, I was sitting inside another doctor’s office, albeit one filled with a plush “tell me all your problems” couch and a box of tissues instead of an exam table and lubricating gel, but the message was the same. “Our goal is for you to gain about 30 lbs over the next 3 months, say about 2 pounds a week.” My reaction eleven years ago: I burst into tears, hide my face in an oversized sweatshirt, and silently promise to myself that I will do no such thing. My reaction one week ago: the most nonchalant “okay, sounds good” you can imagine. My how far I’ve come.

Before my husband and I even discussed children, long before I even knew if I wanted kids at all, I was convinced I could not have them. With the slightest mention of babies or grandkids, I would ardently declare, much to mother’s dismay, “I’m never having children…EVER!” Even though I knew it was something I wanted, my fear that I would not be able to have them overtook any optimism and faith I could muster. After years of damaging my body and depriving it of the essentials it needed to develop, how would it have the energy or vitality to create another life? I viewed myself as damaged goods, as irreparable. I labeled my body as defective, and decided I deserved whatever was coming to me. My mind was ready to accept defeat; my body on the other hand, was not.

When I begrudgingly took the first home pregnancy test, I thought I was being paranoid. When the test came back positive I assumed it was defective. When the second came back positive, I believed the whole box to be defective. When, two months later, I looked at the ultrasound monitor and saw our baby for the first time, I was still in disbelief. I was convinced that the image on the screen would display an empty nothingness, but instead, I saw wiggling arms and legs, a defined head, a body, and a heart that was beating despite all my fears and doubts.

Now, I feel like the ambassador, like the protector of this new life growing inside me. I can’t officially claim the title of “mother” yet, but my maternal instincts have kicked into high gear. “What’s that ghost of an eating disorder? You don’t like the idea of gaining weight, of putting someone else’s health and well being above your desire to restrict, to binge, to purge? Well guess what, I don’t care.” It’s interesting how easy it is now to shut off the voices in my head that belittle and try to convince me my worth is only skin-deep. It was so difficult when I was only standing up for myself, but now I’m standing up for two, and like the saying goes, strength comes in numbers.

I’m not going to lie; I am terrified of becoming a mom. I’m terrified of the power I will soon wield over another person’s life. I’m terrified of the responsibility to nurture, strengthen, inspire, teach, motivate, and love and on the flip-side, the potential to destroy, letdown, scar, and demoralize. I instantly want to protect this baby from every future hardship, from scraped knees to broken hearts, but I know that those are the trials I can’t control once he or she enters the world. But right now, while he’s still just a small fig-sized** baby inside me, I do have the power to protect him. And protecting him from the backlash of my neglected, kicked-to-the-curb eating disorder voice is the least I can do.

Today, at eleven weeks 2 days pregnant, when I look at the small image of the baby hanging on our refrigerator, I’m truly amazed. My body has done what my mind perceived to be impossible: it has healed.

**Thank you babycenter.com for all your fruit and vegetable references. Although, I had to wait until week 11 to post this because normal people don’t know what your week 10 fruit, a kumquat, looks like.

Sticking to a meal plan, whether recovering from an eating disorder or not, is challenging. Just like any other diet*, it can easily be thrown off course by unanticipated or emotionally triggering events. In fact, studies have shown that 95% of all dieters are back at their starting weight within 5 years of beginning a program. While this statistic commonly refers to those on a weight loss regimen, I believe there is a lot of crossover between the problems weight-loss-dieters and weight-gain-dieters encounter.

When I was just out of inpatient and diligently following my meal plan, I was surprised to find that what tripped me up the most wasn’t always the food or the impending weight gain. It was family and friends that didn’t quite understand what I was doing and why. I can’t count the times a well-intended friend pushed a batch of fresh baked brownies my way saying, “I thought you could eat this now.” Well, I would think to myself, I can eat brownies, just not those brownies. I need a brownie made with portion-controlled ingredients measured out with military precision that has been weighed on a digital scale to the exact gram. But since that was quite a mouthful and begged a dozen questions I wasn’t prepared to field, I tended to revert to the polite, “no thank you.”

While adhering to a meal plan often temporarily introduces a whole new slew of food rules, it affords the peace of mind that you are eating within allowable parameters. In a sense, the meal plan gives you a “ticket to eat,” or as my therapist referred to it, “a food prescription.” Initially, it is important to strictly follow the plan as you restore weight, normalize eating, and work through emotional baggage. Going off plan too early can be a slippery slope leading to relapse. Unfortunately, friends and family have the potential to confuse the new recovery-focused food rules for eating disorder behavior. If you combine that with the misunderstanding that recovery from an eating disorder is an overnight occurrence it’s easy to see why the unintentional sabotage occurs.

To help you stick to your meal plan when up against uninformed or unsupportive friends and family members I’ve assembled a list of tips that really helped me.

1) Get comfortable saying NO

You’re armed with the meal plan and you know what you need to eat. If someone offers you food that doesn’t fit in with your recovery plan, just say no. With food and emotions so closely intertwined perhaps saying no to grandma’s home-cooked lasagna or fresh-baked cookies will hurt her feelings, but right now that can’t be your top priority. Thank her for the offer, say no, offer an explanation if your feel comfortable, and then move on.

2) Educate others

Tell those closest to you about your meal plan. If they know what you are doing they will be able to offer support and encouragement instead of criticism or misplaced advice. This also makes you accountable to eat the food on your plan.

3) It’s all in the preparation

Don’t get thrown off because you had to work late, came home tired, and now your family is beckoning you to come eat the pizza they ordered. If you are at a point where you can do some quick mental math and substitute pizza for your planned meal, great! If not, make sure you have some quick back-ups in place, think supplemental drinks, frozen foods, or prepackaged snacks (or, thanks to your newfound raging metabolism, all three).

4) Offer to cook

Do you have a hard time getting your family to understand why you measure everything? Would you like to eat the same meal as everyone else but can’t get the cook to accommodate your needs? Cook a meal for everyone. When you are in the kitchen you can measure the ingredients in your meal to get an accurate count and, unless someone is watching you, they probably won’t be any wiser to what you are doing.

5) Ask for modifications

You never know how accommodating your family will be unless you ask. To this day when I am having a rough day with food I ask my husband to whip out the kitchen scale to make sure my meal is xxx calories. He understands the important role meal planning plays in recovery, and is always willing to oblige. But getting up the courage to ask him is the first step.

6) Get a wingman (or wingwoman)

A wingman comes in handy when your reserves are running low and you can’t bear the thought of explaining one more time why you brought your own food to (insert any family holiday or social gathering). A good wingman can deflect questions, support your decision, encourage you in the face of disapproval, and be your personal advocate in recovery.

7) Be resolute in your recovery

Following a meal plan 100% of the time is hard. If you don’t know why you’re doing it, then it becomes 100x harder. Work on getting to the root reasons for why you want recovery (making a list is helpful-as well as countless hours in therapy) and then work on understanding the important connection between meal planning and recovery.

So gather your measuring cups and spoons, the kitchen scale, and nutritional guides and commit yourself to meal planning. Because in the end, whether or not your family members and friends are on board, you are only accountable to yourself.

I broke my foot exactly 1 month ago, and with it, all my dreams of losing too much weight, overdoing it at the gym, and once again reclaiming my eating disorder glory. Let me explain.

About 2 months ago, I stumbled upon the website sparkpeople.com. Much like diet and exercise trackers I’ve used in the past, it allows you to set a goal weight and a day at which you would like to achieve said goal weight and POOF…. it pumps out a daily calorie allowance and suggested exercise program.

The fact that I searched out this website to begin with says something about my general mental well-being. I’ve been struggling a lot lately with grieving the end, or death if you want to sound more poetic, of my anorexia. I’ve been struggling to fill the void it’s absence has created. At one point in my life eating disordered behaviors could be the answer to almost any question or problem. Feeling bored? Turn to ED. Feeling stressed? Turn to ED. Feeling overwhelmed? Turn to ED. Feeling angry? Turn to ED. You get the idea. Lately, I’ve had to admit to myself that anorexia is no longer my coping method of choice. I’ve had to admit that even if I wished to develop anorexia again, I don’t think I could. Just as much as I didn’t control its onset the first time around, I can’t magically will it into being now. And all that makes me sad.

I liked having an “easy” answer to all life’s problems. I don’t like having to deal with issues in a mature, adult way. I don’t like having to look for alternative coping mechanisms, or what most often happens, not cope at all. Over the past year I have fallen into quite a depressed state, and without my fixation on weight loss, or the sense of accomplishment I get from sticking to a diet, I’ve been hanging out at the bottom of this dark hole for quite some time.

Enter sparkpeople.com. I became hooked on its community based approach to weight loss and point system very quickly. I loved entering my food for the day and seeing the ticker land right between my designated calorie allowance. I loved watching the calories burned bar far surpass the calories consumed bar. I especially loved watching the slope of the line graph indicating weight steadily become steeper and steeper.

In about 1 month’s time I had lost 7 pounds. The depression was starting to lift, and I was feeling on top of the world. I was feeling like a somebody instead of a nobody. And then in a seemingly innocuous fall while playing tennis I broke the base of my 5th metatarsal (aka: a Jones fracture for all you medically minded people). The moment I heard the doctor say it was broken I knew my weight loss plans were over. The tides had been turned and I was bearing straight toward a sea of home alone binges, uncontrollable crying sessions and irrational, nearly suicidal thoughts.

It’s always been that way with me. The moment my plans are disrupted I can no longer stay on course. In effect, I do a complete 180. It’s my all or nothing mentality at its finest. And sitting on that cold, paper-lined hospital table I knew it all too well. I started to cry, not because my foot was broken, but because I knew that meant I was heading into a period of compulsive overeating, purging, and depression. And despite having complete awareness over what was happening, I had no control.

It’s been one month since that accident, my foot is still cast bound, and my follow-up appointment isn’t until September 6. I’ve completely abandoned my sparkpeople account, except for the rare occasion when I wake up committed to track for the day and make it through lunch. Those half days only make me feel bad when I look back over them…reminders of my failure. I’ve tried telling myself that this broken foot was a relapse intervention; it was some higher power’s way of telling me to cut it out. Or it could have been the universe’s way of showing me just how ill equipped I am at overcoming obstacles, how little drive and perseverance I have.

Despite the cast, I still make it to the gym 3-4 times a week, my weight is “only” up about 2 pounds, and I’m managing to eat a more balanced diet than I normally would were I in a typical binge and purge period. I’m hoping once the cast comes off and I get the go ahead to apply weight I can flip the switch again and get back into tracking and out of this funk. I know I should hope for a future that isn’t centered around any extreme eating and exercise behavior, but frankly, I have a hard time imagining what that would look like.

Because it is the thing that makes me most miserable that I also need to find any joy at all.

October 2011 Update: I am completely managing all eating disorder behaviors and have taken this incident as an opportunity to deal with some of the latent emotions I have surrounding the “death” of my eating disorder.

To be resolute or not to be resolute…that is the question. As someone who frequently breaks her New Year’s resolutions (and by frequently I mean 100% of the time), I’m always a little hesitant to make any lest I disappoint myself once again. This year, however, I’m taking a different approach to the whole resolution thing. Instead of viewing my pursued goals as achieved or not achieved, or categorizing them as successes or failures, I’m choosing to view my goals on more of a continuum of sorts. What do I mean by this? Let me give you an example.

A common New Years goal for a lot of people, and I embarrassingly admit for myself too, is to eat healthier and exercise more. So when January 1st rolls around I wake up committed to not eat junk food anymore and to get to the gym at least 5 times a week. By January 3rd I inevitably find myself sitting in front of the television with a bowl of ice cream, wondering how the ice cream even ended up in the apartment since it was not on my list of approved foods. In the past it would be at this point that I admit defeat, throw in the towel, and tell myself to just wait for next year so I can begin my resolution anew.

There are a lot of problems with this situation. First, since when has one bowl of ice cream ever been the downfall of a diet? One bowl of ice cream everyday for an entire month–maybe, but surely not one bowl on one day of one week. Second, I’m applying that all-or-nothing mentality that has served me and my eating disorder all to well in the past (I’m hoping you can detect the sarcasm but just in case I’ll insert this disclaimer). It’s either 100% healthy eating 100% of the time, or I’ve failed. I either go to the gym with the intention of working out for 2 hours straight, or might as well not even go. If I’m forced to eat an unplanned meal out with my family, I might as well go ahead and binge. You get the idea; this way of thinking is neither productive nor healthy. Lastly, if it’s January 3rd and I’m already “breaking” my resolution, it probably wasn’t a very reasonable or sustainable resolution to begin with.

And now you see the purpose of the continuum. Instead of saying I must eat healthy all the time, I am working toward eating healthier most of the time. I’m also redefining what eating healthy means to me. If I do decide to eat that bowl of ice cream on the 3rd, I’ll just be sure to balance it out on the 4th with a little extra cardio and a couple extra servings of vegetables. I’ll strive for balance in my life instead of perfection. Better yet, I’ll redefine perfection to mean balance so that it meets my unique goals; instead of my all-or-nothing thinking of the past. I’ll take baby steps toward my goals and not unrealistically expect that on January 1st I’ll muster up the determination and will power to push myself to the finish line. I know now that the resolutions I set for myself are a work in progress and along the way I will expect to encounter some roadblocks. Instead of viewing those roadblocks as dead ends, I will look at them as part of the struggle to reach my goals and continue on knowing that taking the time to navigate around them is far more productive than turning around and heading back to the starting line.

Back when my eating disorder was the dominant force in my life, I was ready to punch the next person that told me “fat is not a feeling.” I used to get into this debate with my therapist all the time. It went something like this.

Dana: I hate the way I look; none of my clothes fit anymore. I feel so fat.

Therapist: Your weight gain is right on target; no need to worry. And remember Dana, fat is not a feeling. Why don’t you tell me what you really feel: sad, frustrated, scared?

Dana: I feel like I want to punch you (is what I should have said). I don’t know (is more likely what I did say).

Therapist: Fat is a physical state; and you either are or are not fat. You need to ignore your own perception and trust me when I tell you that you are not fat.

Dana: Yes but fat is also a relative term. I feel fat now compared to what I once weighed. Therefore, relatively I feel fat.

Flash forward 10 years, and I weigh in at about 50 pounds heavier than when I previously felt “fat.” The interesting note: I have lots of days when instead of feeling “fat” I feel “normal” or “healthy.” So what’s changed? Most notably it is my perception of what is considered healthy in addition to the fact that I no longer need to use my body nor my weight as a tool for self-expression. I now recognize anorexia for what it is: a disease that distorts perceptions. I recognize extreme thinness as a symptom of the disorder. In the past, I didn’t even recognize my physical condition as a problem that needed correcting. I was healthy I thought, my life was under control and my body reflected that. If I were to gain weight, to give up the disorder, all the calm feelings would leave and my life would be in chaos.

Today I see my body less as a statement of how I am feeling and more as a source of strength, a vehicle to get me to where I am going, and only a small fraction of who I am as a person. With so many more things defining my life, I don’t rely on my body to determine my self-esteem or self-worth or to serve as a temporary fix. Today when I feel “fat” I know it’s because something else in my life is grating on my patience and my body becomes an easy target for expressing my dissatisfaction.

As much as I hate to say it, my therapist was probably right. By calling myself fat and focusing on my appearance I avoided the real issue, which often felt out of my control or too large to tackle. Losing 5 pounds, that I could handle. Resolving the anger and sadness that were building in my head, not quite as easy. Luckily I realize all this now and can act as stand in therapist when the girl I see in the mirror starts to tell me I feel fat. I now look at her and repeat: “fat isn’t a feeling Dana, why not try telling me how you really feel.”